Dr. Zubowicz: In assessing the upper lids, we'd like to see that 8mm or so of what's called lid show. You'll notice it on the left side there is more of the upper lid showing than on the right side. That's where the symmetry is fairly customary. In doing the surgery subsequently, we'll be trying to establish that aesthetic goal.

When looking at the lower lids, we have an entirely different situation. There is herniation of the fat pads which creates a prominence over which, when light passes, it creates a shadow, creating a dark circle under the eye. In this particular case, there is a depression of the bone between the lower eyelid and the nose called the tear trough abnormality. This, often times, is treated in the office with filler, but during the operation we'll use some of the patient's own fat to fill that, obviating any subsequent need for fillers in the future.